Provider Demographics
NPI:1104181064
Name:NOVAK, JOSEPH A (BCBA-D, CCC-SLP, ATP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:NOVAK
Suffix:
Gender:M
Credentials:BCBA-D, CCC-SLP, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 STOCKTON CT
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3405
Mailing Address - Country:US
Mailing Address - Phone:862-812-7066
Mailing Address - Fax:
Practice Address - Street 1:57 STOCKTON CT
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-3405
Practice Address - Country:US
Practice Address - Phone:862-812-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NJ41YS00632100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst